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Systematic Review
The CPSTF recommends client or family incentive rewards, used alone or in combination with additional interventions, based on sufficient evidence of effectiveness in increasing vaccination rates in children and adults.
This Task Force finding is based on evidence from a Community Guide systematic review completed in 2011 (6 studies with 7 study arms, search period 1980-2009) combined with more recent evidence (1 study, search period 2009-2012). Based on the combined evidence, the Task Force reaffirms its recommendation based on sufficient evidence of effectiveness.
Included studies showed vaccination rates increased by a median of 8 percentage points (IQI: 4 to 16 percentage points). Two study arms that assessed the effectiveness of incentive rewards alone showed similar changes in vaccination rates (8.5 and 9.0 percentage points). In the six remaining study arms, incentive rewards were combined with additional interventions.
Among the studies included in this review, the type of incentive reward offered to clients included government payments (i.e., of $208 AUD and childcare assistance), lottery prizes (i.e., $50 grocery voucher or $175 in monetary prizes), gift cards (i.e., $10 for baby products), baby products, and food vouchers.
Overall, the Task Force considers the evidence to be applicable to vaccinations for children and adults in a wide range of clinical and community settings, and for various types of incentive rewards.
This CPSTF concludes that client or family incentive rewards can also be one component of an effective combined approach to increase vaccination rates in both clinical and community settings. Based on updated, concurrent reviews the Task Force finds strong evidence to recommend health care system-based interventions implemented in combination and community-based
interventions implemented in combination.
Additional research could focus on the independent effects of incentive rewards, examine the relationship between the value of the reward and effectiveness, and explore the duration of intervention impact. It also would be useful to have more information about the effectiveness of these interventions with adolescents and adults as most of the included studies examined the use of incentive rewards on vaccination rates for children.